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Many asthma patients shy away from outdoor exercise in the winter because it can trigger an asthma attack. If they take proper precautions, however, the vast majority of asthma patients should be able to enjoy winter activities, from sledding and skiing to a walk in the park.

"Any kind of vigorous exercise can be a trigger for an asthma attack, but the cold dry air of winter can be an especially potent trigger," said National Jewish Health pulmonologist David Beuther, MD.

Heavy exercise causes a person to breathe more air, more rapidly through the mouth, preventing it from being warmed and moistened when inhaled more slowly through the mouth and nose. Exactly how this triggers an asthma attack is still of some debate. Cooling and drying of the airways, and cooling of the body are suspects. But so is the rewarming of the airways after exercise has stopped; many exacerbations occur after a person stops exercising.

Nonetheless, there are several steps people can take to reduce the chances of suffering an exercise-induced asthma attack in winter, or summer.

Make sure you are following your doctors recommendations for managing your asthma.

An exercise-induced asthma attack is often a sign of poorly controlled asthma. "Properly managing your asthma over the long haul is the most effective step you can take to preventing an asthma attack, during exercise or at other times," said Dr. Beuther. Make sure any prescriptions are filled and you are taking the medications as directed, and that you are following any other recommendations your physician has made.

Pretreat 15-30 minutes before going outside.

Pretreating with a short-acting rescue medication such as albuterol (Proventil, Alupent, Maxair, Xopenex) can open the airways and help prevent muscles around them from tightening up. Most of these medications last only two to four hours, so make sure you take the medication along with you during exercise.

Wear a scarf, neck gaiter or mask across your nose and mouth.

This will help warm the cold air you're inhaling and decrease irritation. It will also help keep your airway lining moist.

"If you or your child does have an asthma attack try and stay calm," said Dr. Beuther. "Take deep breaths while taking your prescribed rescue medication."

If these steps do not prevent an asthma attack you should consult your doctor to see if there is something more you can do to better manage your asthma.

"Just about all asthma patients should be able to engage in physical activity, if their asthma is well managed and they take a few simple precautions," said Dr. Beuther.